1
|
Kaur T, Sharma K, Groban L. Subanesthetic Ketamine Infusion Reducing Symptoms of Depression in a Patient With End-Stage Heart Failure Enrolled in Hospice Care: A Case Report. J Palliat Med 2023; 26:1435-1438. [PMID: 37327367 DOI: 10.1089/jpm.2022.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
Background: The development of major depressive disorder in patients at end of life often goes undiagnosed, as it is difficult to distinguish from preparatory grief and/or hypoactive delirium in this unique patient population. If this preliminary barrier of appropriate diagnosis is overcome, it can be quite difficult to properly select and adjust pharmacological therapy. Many well-established antidepressants take four to five weeks for maximal effectiveness (which may be far too long of a titration period for patients at end of life), have various contraindications to patients' comorbid chronic conditions (particularly patients with cardiovascular disease), or may simply be ineffective. Case: We present a case report of severe treatment-resistant depression in an end-stage heart failure patient enrolled in hospice care. Discussion: We discuss the potential use of a single low-dose intravenous racemic ketamine infusion to reduce end-of-life suffering related to depression, despite the theoretical contraindication of ketamine use in such patients, in part, due to its sympathomimetic secondary effect.
Collapse
Affiliation(s)
- Tejaspreet Kaur
- Hospice and Palliative Medicine Department, Advocate Aurora Health, Milwaukee, Wisconsin, USA
- Zilber Family Hospice of Advocate Aurora Health, Milwaukee, Wisconsin, USA
| | - Kavita Sharma
- Hospice and Palliative Medicine Department, Advocate Aurora Health, Milwaukee, Wisconsin, USA
- Zilber Family Hospice of Advocate Aurora Health, Milwaukee, Wisconsin, USA
| | - Leanne Groban
- Hospice and Palliative Medicine Department, Advocate Aurora Health, Milwaukee, Wisconsin, USA
- Zilber Family Hospice of Advocate Aurora Health, Milwaukee, Wisconsin, USA
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| |
Collapse
|
2
|
Ogola BO, Abshire CM, Visniauskas B, Kiley JX, Horton AC, Clark GL, Kilanowski-Doroh I, Diaz Z, Bicego AN, McNally AB, Zimmerman MA, Groban L, Trask AJ, Miller KS, Lindsey SH. Sex Differences in Vascular Aging and Impact of GPER Deletion. Am J Physiol Heart Circ Physiol 2022; 323:H336-H349. [PMID: 35749718 PMCID: PMC9306784 DOI: 10.1152/ajpheart.00238.2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aging is a nonmodifiable risk factor for cardiovascular disease associated with arterial stiffening and endothelial dysfunction. We hypothesized that sex differences exist in vascular aging processes and would be attenuated by global deletion of the G protein-coupled estrogen receptor. Blood pressure was measured by tail cuff plethysmography, pulse wave velocity (PWV) and echocardiography were assessed with high resolution ultrasound, and small vessel reactivity was measured using wire myography in adult (25 weeks) and middle-aged (57 weeks) male and female mice. Adult female mice displayed lower blood pressure and PWV, but this sex difference was absent in middle-aged mice. Aging significantly increased PWV but not blood pressure in both sexes. Adult female carotids were more distensible than males, but this sex difference was lost during aging. Acetylcholine-induced relaxation was greater in female than male mice at both ages, and only males showed aging-induced changes in cardiac hypertrophy and function. GPER deletion removed the sex difference in PWV as well as ex vivo stiffness in adult mice. The sex difference in blood pressure was absent in KO mice and was associated with endothelial dysfunction in females. These findings indicate that the impact of aging on arterial stiffening and endothelial function is not the same in male and female mice. Moreover, nongenomic estrogen signaling through GPER impacted vascular phenotype differently in male and female mice. Delineating sex differences in vascular changes during healthy aging is an important first step in improving early detection and sex-specific treatments in our aging population.
Collapse
Affiliation(s)
- Benard O Ogola
- Tulane University, Department of Pharmacology, New Orleans, LA
| | - Caleb M Abshire
- Tulane University, Department of Pharmacology, New Orleans, LA
| | | | - Jasmine X Kiley
- Tulane University, Department of Biomedical Engineering, New Orleans, LA
| | - Alec C Horton
- Tulane University, Department of Pharmacology, New Orleans, LA
| | - Gabrielle L Clark
- Tulane University, Department of Biomedical Engineering, New Orleans, LA
| | | | - Zaidmara Diaz
- Tulane University, Department of Pharmacology, New Orleans, LA
| | - Anne N Bicego
- Tulane University, Department of Pharmacology, New Orleans, LA
| | | | | | - Leanne Groban
- Wake Forest School of Medicine, Department of Anesthesiology, Winston Salem, NC
| | - Aaron J Trask
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
| | - Kristin S Miller
- Tulane University, Department of Biomedical Engineering, New Orleans, LA
| | - Sarah H Lindsey
- Tulane University, Department of Pharmacology, New Orleans, LA
| |
Collapse
|
3
|
Ogola B, Clark G, Kilanowski‐Doroh I, Visniauskas B, Abshire C, Diaz Z, Horton A, Kiley J, Zimmerman MA, Groban L, Miller K, Lindsey S. Aging and G Protein‐Coupled Estrogen Receptor Exacerbates Carotid Artery Structural Remodeling. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r6256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
4
|
Ferrario CM, Groban L, Wang H, Sun X, VonCannon JL, Wright KN, Ahmad S. The renin–angiotensin system biomolecular cascade: a 2022 update of newer insights and concepts. Kidney Int Suppl (2011) 2022; 12:36-47. [DOI: 10.1016/j.kisu.2021.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 12/30/2022] Open
|
5
|
Ferrario CM, VonCannon JL, Zhang J, Figueroa JP, Wright KN, Groban L, Saha A, Meredith JW, Ahmad S. Immunoneutralization of human angiotensin-(1-12) with a monoclonal antibody in a humanized model of hypertension. Peptides 2022; 149:170714. [PMID: 34933010 PMCID: PMC8985523 DOI: 10.1016/j.peptides.2021.170714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 01/02/2023]
Abstract
We engineered a monoclonal antibody (mAb) against the human C-terminus of angiotensin-(1-12) [h-Ang-(1-12)] and performed a biochemical characterization in concert with direct in vivo and ex vivo (carotid artery strips) assessments of h-Ang-(1-12) vasoconstrictor activity in 78 (36 females) transgenic rats expressing the human angiotensinogen gene [TGR(hAGT)L1623] and 26 (10 female) Sprague Dawley (SD) controls. The mAb shows high specificity in neutralizing angiotensin II formation from h-Ang-(1-12) and did not cross-react with human and rat angiotensins. Changes in arterial pressure and heart rate in Inactin® hydrate anesthetized rats were measured before and after h-Ang-(1-12) injections [dose range: 75-300 pmol/kg i.v.] prior to and 30-60 minutes after administration of the h-Ang-(1-12) mAb. Neutralization of circulating Ang-(1-12) inhibited the pressor action of h-Ang-(1-12), prevented Ang-(1-12) constrictor responses in carotid artery rings in both SD and TGR(hAGT)L1623 rats, and caused a fall in the arterial pressure of male and female transgenic rats. The Ang-(1-12) mAb did not affect the response of comparable dose-related pressor responses to Ang II, pre-immune IgG, or the rat sequence of Ang-(1-12). This h-Ang-(1-12) mAb can effectively suppress the pressor actions of the substrate in the circulation of hypertensive rats or in carotid artery strips from both SD and transgenic rats. The demonstration that this Ang-(1-12) mAb by itself, induced a fall in arterial pressure in transgenic hypertensive rats supports further exploring the potential abilities of Ang-(1-12) mAb in the treatment of hypertension.
Collapse
Affiliation(s)
- Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States.
| | - Jessica L VonCannon
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Jie Zhang
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Jorge P Figueroa
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Kendra N Wright
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Amit Saha
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - J Wayne Meredith
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, 27157, United States
| |
Collapse
|
6
|
Zhang X, Li T, Cheng HJ, Wang H, Ferrario CM, Groban L, Cheng CP. Chronic GPR30 agonist therapy causes restoration of normal cardiac functional performance in a male mouse model of progressive heart failure: Insights into cellular mechanisms. Life Sci 2021; 285:119955. [PMID: 34520767 DOI: 10.1016/j.lfs.2021.119955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/21/2021] [Accepted: 09/08/2021] [Indexed: 01/22/2023]
Abstract
AIMS G protein-coupled estrogen receptor 30 (GPR30) activation by its agonist, G1, exhibits beneficial actions in female with heart failure (HF). Recent evidence indicates its cardiovascular benefits may also include male as well. However, whether and how GPR30 activation may limit HF progression and have a salutary role in males is unknown. We hypothesized that chronic G1 treatment improves LV and cardiomyocyte function, [Ca2+]i regulation and β-adrenergic reserve, thus limiting HF progression in male. MAIN METHODS We compared left ventricle (LV) and myocyte function, [Ca2+]i transient ([Ca2+]iT) and β-AR modulation in control male mice (12/group) and isoproterenol-induced HF (150 mg/kg s.c. for 2 days). Two weeks after isoproterenol injection, HF mice received placebo, or G1 (150 μg/kg/day s.c. mini-pump) for 2 weeks. KEY FINDINGS Isoproterenol-treated mice exhibited HF with preserved ejection fraction (HFpEF) at 2-weeks and progressed to HF with reduced EF (HFrEF) at 4-weeks, manifested by significantly increased LV time constant of relaxation (τ), decreased EF and mitral flow (dV/dtmax), which were accompanied by reduced myocyte contraction (dL/dtmax), relaxation (dR/dtmax) and [Ca2+]iT. Acute isoproterenol-superfusion caused significantly smaller increases in dL/dtmax, dR/dtmax and [Ca2+]iT. G1 treatment in HF increased basal and isoproterenol-stimulated increases in EF and LV contractility of EES. Importantly, G1 improved basal and isoproterenol-stimulated dL/dtmax, dR/dtmax and [Ca2+]iT to control levels and restored normal cardiac β-AR subtypes modulation. SIGNIFICANCE Chronic G1 treatment restores normal myocyte basal and β-AR-stimulated contraction, relaxation, and [Ca2+]iT, thereby reversing LV dysfunction and playing a rescue role in a male mouse model of HF.
Collapse
Affiliation(s)
- Xiaowei Zhang
- Department of Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Tiankai Li
- Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America; Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Heng-Jie Cheng
- Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| | - Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| | - Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| | - Che Ping Cheng
- Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| |
Collapse
|
7
|
Alencar AKND, Wang H, Oliveira GMMD, Sun X, Zapata-Sudo G, Groban L. Crossroads between Estrogen Loss, Obesity, and Heart Failure with Preserved Ejection Fraction. Arq Bras Cardiol 2021; 117:1191-1201. [PMID: 34644788 PMCID: PMC8757160 DOI: 10.36660/abc.20200855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
A prevalência de obesidade e insuficiência cardíaca com fração de ejeção preservada (ICFEP) aumenta significativamente em mulheres na pós-menopausa. Embora a obesidade seja um fator de risco para disfunção diastólica do ventrículo esquerdo (DDFVE), o mecanismo que liga a interrupção da produção de hormônios ovarianos, especialmente o estrogênio, ao desenvolvimento da obesidade, DDFVE, e ICFEP em mulheres em processo de envelhecimento não é claro. Estudos clínicos e epidemiológicos demonstram que mulheres na pós-menopausa com obesidade abdominal (definida pela circunferência de cintura) têm risco maior de desenvolver a ICFEP do que homens ou mulheres sem obesidade abdominal. Este estudo analisa dados clínicos que corroboram a existência de uma ligação de mecanismo entre a perda de estrogênio mais obesidade e o remodelamento ventricular esquerdo com ICFEP. Ele também discute os possíveis mecanismos celulares e moleculares para a proteção mediada por estrogênio contra tipos de células, depósitos de tecidos, função e metabolismo de adipócitos negativos que podem contribuir para a DDFVE e a ICFEP.
Collapse
Affiliation(s)
| | - Hao Wang
- Wake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América.,Wake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
| | | | - Xuming Sun
- Wake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gisele Zapata-Sudo
- Universidade Federal do Rio de Janeiro - Instituto de Ciências Biomédicas, Rio de Janeiro, RJ - Brasil.,Universidade Federal do Rio de Janeiro - Instituto de Cardiologia Edson Saad, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Leanne Groban
- Wake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América.,Wake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
| |
Collapse
|
8
|
Sun X, Wang H, Hodge H, Wright KN, Ahmad S, Ferrario CM, Groban L. Amplifying effect of chronic lisinopril therapy on diastolic function and the angiotensin-(1-7) Axis by the G1 agonist in ovariectomized spontaneously hypertensive rats. Transl Res 2021; 235:62-76. [PMID: 33915312 DOI: 10.1016/j.trsl.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
G protein-coupled estrogen receptor (GPER) activation by G1 attenuates diastolic dysfunction from estrogen loss, which may be partly due to suppression of angiotensin II pathological actions. We aimed to determine the independent effects of 8 weeks of G1 (100 µg/kg/d, subcutaneous pellet), ACE-inhibition (ACEi; lisinopril 10 mg/kg, drinking water), or combination therapy versus vehicle in the ovariectomized (OVX) spontaneously hypertensive rat (SHR) on cardiac function and morphometrics (echocardiography), serum equilibrium of angiotensins (mass spectroscopy) and cardiac components of the RAS (Western blotting). G1 alone and when combined with ACEi enhanced myocardial relaxation (é: 30 and 17%) and diastolic wall strain (DWS: 76 and 68%) while reducing relative wall thickness (RWT: 20 and 33%) and filling pressures (E/é: 30 and 37%). Cardiac expression levels of Mas receptor (Mas-R) and ACE2 also increased in the presence of G1. Strong antihypertensive effects of lisinopril monotherapy were associated with reductions in RWT, collagen deposition and E/é without overtly altering é or DWS. Chronic ACEi also increased cardiac levels of Mas-R and AT1-R and tilted the circulating RAS toward the formation of Ang-(1-7), which was amplified in the presence of G1. In vitro studies further revealed that an inhibitor to prolyl endopeptidase (PEP), but not to neprilysin, significantly reduced serum Ang-(1-7) levels in G1-treated rats, suggesting that G1 might be increasing Ang-(1-7) formation via PEP. We conclude that activating GPER with G1 augments components of the cardiac RAS and improves diastolic function without lowering blood pressure, and that lisinopril-induced blood pressure control and cardiac alterations in OVX SHR are permissive in facilitating G1 to augment Ang-(1-7) in serum, thereby strengthening its cardioprotective benefits.
Collapse
Affiliation(s)
- Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Hunter Hodge
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Kendra N Wright
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina.
| |
Collapse
|
9
|
Ogola BO, Clark GL, Abshire CM, Harris NR, Gentry KL, Gunda SS, Kilanowski-Doroh I, Wong TJ, Visniauskas B, Lawrence DJ, Zimmerman MA, Bayer CL, Groban L, Miller KS, Lindsey SH. Sex and the G Protein-Coupled Estrogen Receptor Impact Vascular Stiffness. Hypertension 2021; 78:e1-e14. [PMID: 34024124 PMCID: PMC8192475 DOI: 10.1161/hypertensionaha.120.16915] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Benard O. Ogola
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Gabrielle L. Clark
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Caleb M. Abshire
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Kaylee L. Gentry
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Shreya S. Gunda
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Tristen J. Wong
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Dylan J. Lawrence
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | | | - Carolyn L. Bayer
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristin S. Miller
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Sarah H. Lindsey
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| |
Collapse
|
10
|
Ferrario CM, Groban L, Wang H, Cheng CP, VonCannon JL, Wright KN, Sun X, Ahmad S. The Angiotensin-(1-12)/Chymase axis as an alternate component of the tissue renin angiotensin system. Mol Cell Endocrinol 2021; 529:111119. [PMID: 33309638 PMCID: PMC8127338 DOI: 10.1016/j.mce.2020.111119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 02/08/2023]
Abstract
The identification of an alternate extended form of angiotensin I composed of the first twelve amino acids at the N-terminal of angiotensinogen has generated new knowledge of the importance of noncanonical mechanisms for renin independent generation of angiotensins. The human sequence of the dodecapeptide angiotensin-(1-12) [N-Asp1-Arg2-Val3-Tyr4-Ile5-His6-Pro7-Phe8-His9-Leu10-Val1-Ile12-COOH] is an endogenous substrate that in the rat has been documented to be present in multiple organs including the heart, brain, kidney, gut, adrenal gland, and the bone marrow. Newer studies have confirmed the existence of Ang-(1-12) as an Ang II-forming substrate in the blood and heart of normal and diseased patients. Studies to-date document that angiotensin II generation from angiotensin-(1-12) does not require renin participation while chymase rather than angiotensin converting enzyme shows high catalytic activity in converting this tissue substrate into angiotensin II directly.
Collapse
Affiliation(s)
- Carlos M Ferrario
- Department of Surgery and Physiology-Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA.
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Che Ping Cheng
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Jessica L VonCannon
- Department of Surgery and Physiology-Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Kendra N Wright
- Department of Surgery and Physiology-Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Sarfaraz Ahmad
- Department of Surgery and Physiology-Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| |
Collapse
|
11
|
Ahmad S, Punzi HA, Wright KN, Groban L, Ferrario CM. Newly developed radioimmunoassay for Human Angiotensin-(1-12) measurements in plasma and urine. Mol Cell Endocrinol 2021; 529:111256. [PMID: 33798634 PMCID: PMC8694336 DOI: 10.1016/j.mce.2021.111256] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/10/2020] [Accepted: 03/20/2021] [Indexed: 12/17/2022]
Abstract
The dodecapeptide angiotensin-(1-12) [Ang-(1-12)] functions as an intracrine/paracrine substrate for local production of angiotensin II. We developed a reliable and specific radioimmunoassay (RIA) method for the measurement of Ang-(1-12) in human plasma and urine using an affinity purified antibody fraction directed towards the C-terminus of the human Ang-(1-12) sequence. The RIA method was applied to quantify the Ang-(1-12) in plasma and urine collected from thirty-four human subjects (29 treated with antihypertensive medicines and 5 untreated patients). Plasma Ang-(1-12) level was significantly higher (P < 0.05) in patients with systolic blood pressure ≥140 mm Hg (n = 10) compared to the group with systolic blood pressure <140 mm Hg (n = 24). No significant difference (P = 0.22) was found in spot urine between the groups. Our study also shows that the polyclonal antibody neutralizes the cleavage sites of the human Ang-(1-12) from recombinant human chymase (rhChymase) and serum angiotensin converting enzyme (ACE) mediated Ang II generating hydrolysis. Overall, this newly developed RIA method is reliable and applicable to accurately quantify the Ang-(1-12) level in clinical samples (plasma and urine). Further, our in vitro neutralization study suggests that the anti-Ang-(1-12)-antibody might be used as an in vivo therapeutic agent for preventing Ang-(1-12)/Ang II-mediated hypertension and organ damage.
Collapse
Affiliation(s)
- Sarfaraz Ahmad
- Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
| | - Henry A Punzi
- Trinity Hypertension & Metabolic Research Institute, UT Southwestern Medical Center, Carrollton, TX, 75006, USA
| | - Kendra N Wright
- Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Carlos M Ferrario
- Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA; Department of Physiology-Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| |
Collapse
|
12
|
Kim S, Hsu FC, Groban L, Williamson J, Messier S. A pilot study of aquatic prehabilitation in adults with knee osteoarthritis undergoing total knee arthroplasty - short term outcome. BMC Musculoskelet Disord 2021; 22:388. [PMID: 33902505 PMCID: PMC8074697 DOI: 10.1186/s12891-021-04253-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is increasingly more prevalent and significant number of patients require knee arthroplasty. Although knee arthroplasty is generally successful, it takes months to recover physical function. Preoperative physical function is known to predict postoperative outcomes and exercise can improve preoperative physical function. However, patients with KOA have difficulty exercise on land due to pain and stiffness, while water exercise can be better tolerated. We hypothesized that preoperative water exercise to improve preoperative physical function will improve postoperative outcomes after total knee arthroplasty (TKA). METHODS We enrolled 43 participants who were scheduled for elective TKA in 4-8 weeks and scored at or below 50th percentile in mobility assessment tool-sf (MAT-sf). All enrolled participants were assessed on 1) clinical osteoarthritis symptom severity using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 2) physical function using Short Physical Performance Battery (SPPB), 3) self-reported mobility using Mobility Assessment Tool-short form (MAT-sf), 4) depression using Geriatric Depression Scale-short form (GDS-sf), 5) cognitive function using Montreal Cognitive Assessment (MoCA). Blood samples for high-sensitivity-C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were stored at - 80 °C then all samples were analyzed together. All the enrolled participants were randomly assigned to the aquatic exercise intervention (AEI) or usual care group. Sixty minute sessions of AEI was conducted three times a week for 4-8 weeks. Participants in both groups were evaluated within 1 week before their scheduled surgery, as well as 4 weeks after the surgery. RESULTS The mean age was 67.1 (±6.2), 44% were female, 74% were White. There is no statistically significant difference in combined outcome of any complication, unscheduled ER visit, and disposition to nursing home or rehab facility by AEI. However, AEI was associated with more favorable outcomes: WOMAC scores (p < 0.01), chair-stand (p = 0.019), MAT-sf as well as improved depression (p = 0.043) and cognition (p = 0.008). CONCLUSION 4-8 weeks of aquatic exercise intervention resulted in improved functional outcomes as well as improved depression and cognition in elderly patients undergoing TKA. A larger study is warranted to explore the role of water exercise in clinical and functional outcomes of TKA.
Collapse
Affiliation(s)
- Sunghye Kim
- Department of Internal Medicine, Section of Rheumatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
- Department of Medicine, Section of Rheumatology, W.G. Hefner VA Medical Center, Salisbury, NC, USA.
| | - Fang-Chi Hsu
- Division of Public Health Sciences, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeff Williamson
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
13
|
Wang H, Saha AK, Sun X, Kon ND, Ferrario CM, Groban L. Atrial appendage angiotensin-converting enzyme-2, aging and cardiac surgical patients: a platform for understanding aging-related coronavirus disease-2019 vulnerabilities. Curr Opin Anaesthesiol 2021; 34:187-198. [PMID: 33606395 PMCID: PMC8249166 DOI: 10.1097/aco.0000000000000965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Hospitalizations for COVID-19 dramatically increase with age. This is likely because of increases in fragility across biological repair systems and a weakened immune system, including loss of the cardiorenal protective arm of the renin--angiotensin system (RAS), composed of angiotensin-converting enzyme-2 (ACE2)/angiotensin-(1--7) [Ang-(1--7)] and its actions through the Mas receptor. The purpose of this review is to explore how cardiac ACE2 changes with age, cardiac diseases, comorbid conditions and pharmaceutical regimens in order to shed light on a potential hormonal unbalance facilitating SARs-CoV-2 vulnerabilities in older adults. RECENT FINDINGS Increased ACE2 gene expression has been reported in human hearts with myocardial infarction, cardiac remodeling and heart failure. We also found ACE2 mRNA in atrial appendage tissue from cardiac surgical patients to be positively associated with age, elevated by certain comorbid conditions (e.g. COPD and previous stroke) and increased in conjunction with patients' chronic use of antithrombotic agents and thiazide diuretics but not drugs that block the renin--angiotensin system. SUMMARY Cardiac ACE2 may have bifunctional roles in COVID-19 as ACE2 not only mediates cellular susceptibility to SARS-CoV-2 infection but also protects the heart via the ACE2/Ang-(1--7) pathway. Linking tissue ACE2 from cardiac surgery patients to their comorbid conditions and medical regimens provides a unique latform to address the influence that altered expression of the ACE2/Ang-(1-7)/Mas receptor axis might have on SARs-CoV-2 vulnerability in older adults.
Collapse
Affiliation(s)
- Hao Wang
- Department of Anesthesiology of Wake Forest School of Medicine, Winston Salem, North Carolina
- Department of Internal Medicine-Section of Molecular Medicine of Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Amit K. Saha
- Department of Anesthesiology of Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Xuming Sun
- Department of Anesthesiology of Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Neal D. Kon
- Department of Cardiothoracic Surgery of Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Carlos M. Ferrario
- Department of General Surgery of Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Leanne Groban
- Department of Anesthesiology of Wake Forest School of Medicine, Winston Salem, North Carolina
- Department of Internal Medicine-Section of Molecular Medicine of Wake Forest School of Medicine, Winston Salem, North Carolina
| |
Collapse
|
14
|
Groban L. Editorial: Anesthesia for the older surgical patient: beyond standard care? Curr Opin Anaesthesiol 2021; 34:25-26. [PMID: 33284151 DOI: 10.1097/aco.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Leanne Groban
- Departments of Anesthesiology and Internal Medicine Section of Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| |
Collapse
|
15
|
Ferrario CM, Iyer SR, Burnett JC, Ahmad S, Wright KN, VonCannon JL, Saha A, Groban L. Angiotensin (1-12) in Humans With Normal Blood Pressure and Primary Hypertension. Hypertension 2021; 77:882-890. [PMID: 33461312 DOI: 10.1161/hypertensionaha.120.16514] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of canonical versus noncanonical mechanisms for the generation of angiotensins remains a major challenge that, in part, is heavily swayed by the relative efficacy of therapies designed to inhibit renin, ACE (angiotensin-converting enzyme), or the Ang II (Angiotensin II) receptor. Ang (1-12) (angiotensin [1-12]) is an Ang II forming substrate serving as a source for Ang II-mediated tissue actions. This study identifies for the first time the presence of Ang (1-12) in the blood of 52 normal (22 women) and 19 (13 women) patients with hypertension not receiving antihypertensive medication at the time of the study. Normal subjects of comparable ages and body habitus had similar circulating plasma Ang (1-12) concentrations (women: 2.02±0.62 [SD] ng/mL; men 2.05±0.55 [SD] ng/mL, P>0.05). The higher values of plasma Ang (1-12) concentrations in hypertensive men (2.51±0.49 ng/mL, n=6) and women (2.33±0.63 [SD] ng/mL, n=13) were statistically significant (P<0.02) and correlated with elevated plasma renin activity, systolic and pulse pressure, and plasma concentrations of NT-proBNP (N-terminal prohormone BNP). The increased plasma Ang (1-12) in patients with hypertension was not mirrored by similar changes in plasma angiotensinogen and Ang II concentrations. The first identification of an age-independent presence of Ang (1-12) in the blood of normotensive subjects and patients with hypertension, irrespective of sex, implicates this non-renin dependent substrate as a source for Ang II production in the blood and its potential contribution to the hypertensive process.
Collapse
Affiliation(s)
- Carlos M Ferrario
- Department of Surgery (C.M.F., S.A., K.N.W., J.L.V.), Wake Forest School of Medicine, Winston Salem, NC
| | - Seethalakshmi R Iyer
- Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.R.I., J.C.B.)
| | - John C Burnett
- Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (S.R.I., J.C.B.)
| | - Sarfaraz Ahmad
- Department of Surgery (C.M.F., S.A., K.N.W., J.L.V.), Wake Forest School of Medicine, Winston Salem, NC
| | - Kendra N Wright
- Department of Surgery (C.M.F., S.A., K.N.W., J.L.V.), Wake Forest School of Medicine, Winston Salem, NC
| | - Jessica L VonCannon
- Department of Surgery (C.M.F., S.A., K.N.W., J.L.V.), Wake Forest School of Medicine, Winston Salem, NC
| | - Amit Saha
- Department of Anesthesiology (A.S., L.G.), Wake Forest School of Medicine, Winston Salem, NC
| | - Leanne Groban
- Department of Anesthesiology (A.S., L.G.), Wake Forest School of Medicine, Winston Salem, NC
| |
Collapse
|
16
|
Groban L, Sun X, Sivanandane S, Hodge H, Wang H, Lin M, Opara E. Cell-Based and Pharmacologic Hormone Therapy Maintain Diastolic Function After Ovariectomy in Hypertensive Rats. Innov Aging 2020. [PMCID: PMC7741154 DOI: 10.1093/geroni/igaa057.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The role for hormone therapy in the maintenance of diastolic function upon ovarian senescence has not been clinically tested due to concerns for off-target health risks. We developed a cell-based hormone therapy (cHT) approach that recapitulates native cell–cell interactions between ovarian granulosa and theca cells in a 3D bioengineered construct to mimic the dynamic release of sex hormones. Our first report in ovariectomized (OVX) rats shows that cHT ameliorates various adverse somatic effects of hormone deficiency (e.g. bone loss). To extend these findings to cardiac health, we sought to determine the efficacy of cHT in preserving diastolic function in OVX-spontaneously hypertensive rats (SHR). 14 SHRs underwent bilateral OVX while 5 SHRs received sham surgery at 12 weeks of age. Following an 8-week washout, OVX rats were randomized to cHT or pharmacologic hormone therapy (pHT: E2 (10 mcg/kg/day) and P4 (2 mg/kg/day, s.c.) for 10 weeks and compared to OVX-vehicle and Sham. While uterine atrophy by OVX was minimized by cHT and pHT, hormone levels across OVX groups were not overtly different. Systolic blood pressure increased progressively over time (P<0.01), without a treatment effect. Even so, cHT and pHT prevented OVX-related reductions in myocardial relaxation and increases in Doppler-derived filling (P<0.05); paralleling the diastolic profile of Sham. Alongside superior diastolic function, 25% increases in cardiac interferon regulatory factor-4 (Irf-4) gene expression levels occurred in both hormone-treated OVX groups and Sham when compared to OVX-vehicle, suggesting a link between sex hormones and local immune modulation in the regulation of female cardiac health.
Collapse
Affiliation(s)
- Leanne Groban
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Xuming Sun
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | | | - Hunter Hodge
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Hao Wang
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Marina Lin
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Emmanuel Opara
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| |
Collapse
|
17
|
Affiliation(s)
- Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, USA. .,Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA.
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, USA
| |
Collapse
|
18
|
Ferrario CM, Ahmad S, Groban L. Twenty years of progress in angiotensin converting enzyme 2 and its link to SARS-CoV-2 disease. Clin Sci (Lond) 2020; 134:2645-2664. [PMID: 33063823 PMCID: PMC9055624 DOI: 10.1042/cs20200901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022]
Abstract
The virulence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the aggressive nature of the disease has transformed the universal pace of research in the desperate attempt to seek effective therapies to halt the morbidity and mortality of this pandemic. The rapid sequencing of the SARS-CoV-2 virus facilitated identification of the receptor for angiotensin converting enzyme 2 (ACE2) as the high affinity binding site that allows virus endocytosis. Parallel evidence that coronavirus disease 2019 (COVID-19) disease evolution shows greater lethality in patients with antecedent cardiovascular disease, diabetes, or even obesity questioned the potential unfavorable contribution of angiotensin converting enzyme (ACE) inhibitors or angiotensin II (Ang II) receptor blockers as facilitators of adverse outcomes due to the ability of these therapies to augment the transcription of Ace2 with consequent increase in protein formation and enzymatic activity. We review, here, the specific studies that support a role of these agents in altering the expression and activity of ACE2 and underscore that the robustness of the experimental data is associated with weak clinical long-term studies of the existence of a similar regulation of tissue or plasma ACE2 in human subjects.
Collapse
Affiliation(s)
- Carlos M. Ferrario
- Departments of Surgery and Physiology-Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, U.S.A
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, U.S.A
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, U.S.A
| |
Collapse
|
19
|
Wang H, Varagic J, Nagata S, Kon ND, Ahmad S, VonCannon JL, Wright KN, Sun X, Deal D, Groban L, Ferrario CM. Atrial angiotensin-(1-12)/chymase expression data in patient of heart diseases. Data Brief 2020; 31:105744. [PMID: 32490094 PMCID: PMC7256457 DOI: 10.1016/j.dib.2020.105744] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/15/2020] [Indexed: 12/15/2022] Open
Abstract
The data presented here are related to the research article entitled “Differential expression of the angiotensin-(1-12) [Ang-(1-12)]/chymase axis in human atrial tissue [1]. We have showed that chymase gene transcripts, chymase activity, and immunoreactive- Ang-(1-12) expression levels were higher in left compared to right atrial tissue, irrespective of cardiac disease. This article presents the echocardiographic characteristics of 111 patients undergoing heart surgery for the correction of valvular heart disease, resistant atrial fibrillation or ischemic heart disease. Left atrial chymase mRNA expression and activity, and left atrial Ang-(1-12) levels were compared between patients with stroke vs. non-stroke, congestive heart failure vs. non-heart failure, and in cardiac surgery patients who had a history of postoperative atrial fibrillation vs. non-atrial fibrillation.
Collapse
Affiliation(s)
- Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jasmina Varagic
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Physiology & Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sayaka Nagata
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Neal D Kon
- Department of Cardiothoracic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jessica L VonCannon
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kendra N Wright
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dwight Deal
- Department of Cardiothoracic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Physiology & Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
20
|
|
21
|
Ogola BO, Zimmerman MA, Harris NR, Kilanowski-Doroh I, Groban L, Lindsey S. Impact of Aging and G Protein‐Coupled Estrogen Receptor Deletion in Arterial Stiffening and Cardiac Function in Male and Female Mice. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.06137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
22
|
Groban L, Sun X, Sivanandane S, Wang H, Hodge HS, Basu S, Kim-Shapiro DG, Opara EC. Cell‐based hormone therapy prevents diastolic dysfunction after estrogen loss in the Spontaneously Hypertensive Rat (SHR). FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
23
|
Groban L, Sun X, Hodge HS, Ferrario CM, Wang H. Therapeutic Nrf2 Activation improves LV function in the cardiomyocyte‐specific GPER knockdown mouse. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.07368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
24
|
Michalson KT, Groban L, Howard TD, Shively CA, Sophonsritsuk A, Appt SE, Cline JM, Clarkson TB, Carr JJ, Kitzman DW, Register TC. Estradiol Treatment Initiated Early After Ovariectomy Regulates Myocardial Gene Expression and Inhibits Diastolic Dysfunction in Female Cynomolgus Monkeys: Potential Roles for Calcium Homeostasis and Extracellular Matrix Remodeling. J Am Heart Assoc 2019; 7:e009769. [PMID: 30571375 PMCID: PMC6404177 DOI: 10.1161/jaha.118.009769] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Left ventricular (LV) diastolic dysfunction often precedes heart failure with preserved ejection fraction, the dominant form of heart failure in postmenopausal women. The objective of this study was to determine the effect of oral estradiol treatment initiated early after ovariectomy on LV function and myocardial gene expression in female cynomolgus macaques. Methods and Results Monkeys were ovariectomized and randomized to receive placebo (control) or oral estradiol at a human‐equivalent dose of 1 mg/day for 8 months. Monkeys then underwent conventional and tissue Doppler imaging to assess cardiac function, followed by transcriptomic and histomorphometric analyses of LV myocardium. Age, body weight, blood pressure, and heart rate were similar between groups. Echocardiographic mitral early and late inflow velocities, mitral annular velocities, and mitral E deceleration slope were higher in estradiol monkeys (all P<0.05), despite similar estimated LV filling pressure. MCP1 (monocyte chemoattractant protein 1) and LV collagen staining were lower in estradiol animals (P<0.05). Microarray analysis revealed differential myocardial expression of 40 genes (>1.2‐fold change; false discovery rate, P<0.05) in estradiol animals relative to controls, which implicated pathways associated with better calcium ion homeostasis and muscle contraction and lower extracellular matrix deposition (P<0.05). Conclusions Estradiol treatment initiated soon after ovariectomy resulted in enhanced LV diastolic function, and altered myocardial gene expression towards decreased extracellular matrix deposition, improved myocardial contraction, and calcium homeostasis, suggesting that estradiol directly or indirectly modulates the myocardial transcriptome to preserve cardiovascular function.
Collapse
Affiliation(s)
- Kristofer T. Michalson
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - Leanne Groban
- Department of AnesthesiologyWake Forest University School of MedicineWinston‐SalemNC
| | - Timothy D. Howard
- Department of BiochemistryWake Forest University School of MedicineWinston‐SalemNC
| | - Carol A. Shively
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - Areepan Sophonsritsuk
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - Susan E. Appt
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - J. Mark Cline
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - Thomas B. Clarkson
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| | - J. Jeffrey Carr
- Department of RadiologyVanderbilt University School of MedicineNashvilleTN
| | - Dalane W. Kitzman
- Section on CardiologyDepartment of Internal MedicineWake Forest University School of MedicineWinston‐SalemNC
| | - Thomas C. Register
- Section on Comparative MedicineDepartment of PathologyWake Forest University School of MedicineWinston‐SalemNC
| |
Collapse
|
25
|
Yamashita T, Ahmad S, Wright KN, Roberts DJ, VonCannon JL, Wang H, Groban L, Dell'Italia LJ, Ferrario CM. Noncanonical Mechanisms for Direct Bone Marrow Generating Ang II (Angiotensin II) Predominate in CD68 Positive Myeloid Lineage Cells. Hypertension 2019; 75:500-509. [PMID: 31813348 DOI: 10.1161/hypertensionaha.119.13754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bone marrow (BM) Ang II (angiotensin II) is a major participant in the regulation of hematopoiesis and immunity. The novel tissue substrate Ang-(1-12) [angiotensin-(1-12)] and its cleaving enzyme chymase are an essential source of Ang II production in cardiac tissue. We hypothesized this noncanonical chymase-mediated Ang II-producing mechanism exists in the BM tissue. Immunohistostaining and flow cytometry confirmed the presence of Ang-(1-12) immunoreaction in the BM of SD (Sprague Dawley) rats. Chymase-mediated Ang II-producing activity in BM was ≈1000-fold higher than ACE (angiotensin-converting enzyme)-mediated Ang II-producing activity (4531±137 and 4.2±0.3 fmol/min per mg, respectively; n=6; P<0.001) and 280-fold higher than chymase activity in the left ventricle of 16.3±1.7 fmol/min per mg (P<0.001). Adding a selective chymase inhibitor, TEI-F00806, eliminated almost all 125I-Ang II production. Flow cytometry demonstrated that delta median fluorescence intensity of chymase in cluster of differentiation 68 positive cells was significantly higher than that in cluster of differentiation 68 negative cells (1546±157 and 222±48 arbitrary units, respectively; P=0.0021). Cluster of differentiation 68 positive and side scatter low subsets, considered to be myeloid progenitors, express the highest chymase fluorescence intensity in rat BM. Chymase activity and cellular expression was similar in both male and female rats. In conclusion, myeloid lineage cells, especially myeloid progenitors, have an extraordinary Ang II-producing activity by chymase in the BM.
Collapse
Affiliation(s)
- Tomohisa Yamashita
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Sarfaraz Ahmad
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kendra N Wright
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Drew J Roberts
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Jessica L VonCannon
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Hao Wang
- Department of Anesthesiology (H.W., L.G.), Wake Forest School of Medicine, Winston-Salem, NC.,Department of Internal Medicine-Molecular Medicine; (H.W., L.G.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Leanne Groban
- Department of Anesthesiology (H.W., L.G.), Wake Forest School of Medicine, Winston-Salem, NC.,Department of Internal Medicine-Molecular Medicine; (H.W., L.G.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Louis J Dell'Italia
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham (L.J.D.)
| | - Carlos M Ferrario
- From the Department of Surgery (T.Y., S.A., K.N.W., D.J.R., J.L.V., C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC.,Department of Physiology-Pharmacology (C.M.F.), Wake Forest School of Medicine, Winston-Salem, NC
| |
Collapse
|
26
|
Ferrario CM, VonCannon J, Ahmad S, Wright KN, Roberts DJ, Wang H, Yamashita T, Groban L, Cheng CP, Collawn JF, Dell'Italia LJ, Varagic J. Activation of the Human Angiotensin-(1-12)-Chymase Pathway in Rats With Human Angiotensinogen Gene Transcripts. Front Cardiovasc Med 2019; 6:163. [PMID: 31803758 PMCID: PMC6872498 DOI: 10.3389/fcvm.2019.00163] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/28/2019] [Indexed: 12/16/2022] Open
Abstract
Angiotensin-(1-12) [Ang-(1-12)], an alternate substrate for tissue angiotensin II (Ang II) formation, underscores the importance of alternative renin-independent pathway(s) for the generation of angiotensins. Since renin enzymatic activity is species-specific, a transgenic model of hypertension due to insertion of the human angiotensinogen (AGT) gene in Sprague Dawley rats allowed for characterizing the contribution of a non-renin dependent mechanism for Ang II actions in their blood and heart tissue. With this in mind, we investigated whether TGR(hAGT)L1623 transgenic rats express the human sequence of Ang-(1-12) before and following a 2-week oral therapy with the type I Ang II receptor (AT1-R) antagonist valsartan. Plasma and cardiac expression of angiotensins, plasma renin activity, cardiac angiotensinogen, and chymase protein and the enzymatic activities of chymase, angiotensin converting enzyme (ACE) and ACE2 were determined in TGR(hAGT)L1623 rats given vehicle or valsartan. The antihypertensive effect of valsartan after 14-day treatment was associated with reduced left ventricular wall thickness and augmented plasma concentrations of angiotensin I (Ang I) and Ang II; rat and human concentrations of angiotensinogen or Ang-(1-12) did not change. On the other hand, AT1-R blockade produced a 55% rise in left ventricular content of human Ang-(1-12) concentration and no changes in rat cardiac Ang-(1-12) levels. Mass-Spectroscopy analysis of left ventricular Ang II content confirmed a >4-fold increase in cardiac Ang II content in transgenic rats given vehicle; a tendency for decreased cardiac Ang II content following valsartan treatment did not achieve statistical significance. Cardiac chymase and ACE2 activities, significantly higher than ACE activity in TGR(hAGT)L1623 rats, were not altered by blockade of AT1-R. We conclude that this humanized model of angiotensinogen-dependent hypertension expresses the human sequence of Ang-(1-12) in plasma and cardiac tissue and responds to blockade of AT1-R with further increases in the human form of cardiac Ang-(1-12). Since rat renin has no hydrolytic activity on human angiotensinogen, the study confirms and expands knowledge of the importance of renin-independent mechanisms as a source for Ang II pathological actions.
Collapse
Affiliation(s)
- Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Department of Physiology-Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jessica VonCannon
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Kendra N Wright
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Drew J Roberts
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Hao Wang
- Department of Anesthesia, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Tomohisa Yamashita
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Leanne Groban
- Department of Anesthesia, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Che Ping Cheng
- Section on Cardiovascular Center, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - James F Collawn
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, United States
| | - Louis J Dell'Italia
- Division of Cardiovascular Disease, University of Alabama at Birmingham School of Medicine, Birmingham, AL, United States
| | - Jasmina Varagic
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States.,Section on Cardiovascular Center, Wake Forest School of Medicine, Winston-Salem, NC, United States
| |
Collapse
|
27
|
Yamashita T, Ahmad S, Wright KN, Roberts DJ, VonCannon JL, Varagic J, Sun X, Wang H, Groban L, Ferrario CM. Abstract P131: A Selective Chymase Inhibitor, TEI-f00806, Eliminates the Ang II Production From Rat Ang-(1-12) in Bone Marrow Tissue. Hypertension 2019. [DOI: 10.1161/hyp.74.suppl_1.p131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Rat bone marrow (BM)-chimeric experiments reveal a critical role of locally formed angiotensin II (Ang II) in mediating the oxidant-rich inflammatory milieu associated with cardiovascular disease pathogenesis. Extending our first demonstration of renin angiotensin system (RAS) components in the BM, we recently reported a primary role of chymase rather than angiotensin converting enzyme (ACE) in BM generation of Ang II from the novel substrate angiotensin-(1-12) [Ang-(1-12)]. To verify chymase contribution over other proteases such as cathepsins, Ang-(1-12) metabolism studies in rat BM were carried out in the absence and in the presence of a selective orally active chymase inhibitor (TEI-F00806).
Methods:
Plasma membrane (PM) of BM and left ventricle (LV) tissues were obtained from 12 week-old Sprague Dawley rats following systemic perfusion with phosphate buffered saline with or without the secondary addition of Zamboni’s fixative. PMs were incubated with
125
I-Ang-(1-12) and the metabolic products during incubation were determined by high-performance liquid chromatography. All data were analyzed using GraphPad PRISM 7.0 with P<0.05 to determine statistical significance.
Results:
Assessment of
125
I-Ang-(1-12) hydrolysis in the absence of the chymase inhibitor revealed that chymase activity in BM membranes was 280 fold higher than that in LV (4,531 ± 137 fmol/mg/min and 16.3 ± 0.3 fmol/mg/min, respectively, n = 6, P < 0.001). In the presence of TEI-F00806, 96% of the chymase-mediated Ang II production was inhibited in BM. Confocal microscopy showed chymase-positive but tryptase-negative cells as the most dominant in BM, indicating that stem/progenitor cells rather than mature mast cells might be the source of chymase in BM.
Conclusion:
The current findings demonstrate that BM has tremendously higher chymase-mediated Ang II producing activity from Ang-(1-12) compared to heart tissue. The fact that TEI-00806 inhibited the Ang II producing activity of chymase underscores a tissue-selective enzymatic mechanism for Ang II formation from Ang-(1-12) contributing to the chronic inflammatory processes accompanying the pathogenesis of cardiovascular disease.
Collapse
Affiliation(s)
- Tomohisa Yamashita
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Sarfaraz Ahmad
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Kendra N Wright
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Drew J Roberts
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Jessica L VonCannon
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Jasmina Varagic
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Xuming Sun
- Dept of Anesthesiology, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Hao Wang
- Dept of Anesthesiology, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Leanne Groban
- Dept of Anesthesiology, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| | - Carlos M Ferrario
- Dept of General Surgery, Wake Forest Univ Sch of Medicine, Winston Salem, NC
| |
Collapse
|
28
|
Ahmad S, Wright KN, Varagic J, Groban L, Ferrario CM. Abstract P2033: Rationale For A Novel Approach To Hypertension Treatment Based On Immuno-neutralization Of Angiotensin-(1-12) Catalytic Sites With A Polyclonal Antibody. Hypertension 2019. [DOI: 10.1161/hyp.74.suppl_1.p2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The biochemical pathways for the formation of biological active angiotensins continues to undergo significant revision with the demonstration of angiotensin-(1-12) as an endogenous substrate forming angiotensin II (Ang II) by a non-renin dependent mechanism. Research done in our laboratory established that Ang II generation from Ang-(1-12) is primarily mediated by ACE in the circulation and by chymase in cardiac tissues. In this study, we have utilized an antigen-antibody binding approach to block the cleavage sites of human Ang-(1-12) peptide with an anti-Ang-(1-12) polyclonal antibody (pAb) as a potential therapeutic strategy to prevent the catalytic action of chymase and ACE enzymes to generate Ang II. The pAb was generated against the C-terminus of the human Ang-(1-12) peptide sequence and its specificity for human Ang-(1-12) and cross-reactivity with other angiotensin peptides were determined in competitive binding assays. To block the cleavage sites, the radiolabeled human Ang-(1-12) [
125
I-Ang-(1-12)] substrate was first neutralized by pre-incubating with or without anti-Ang-(1-12) pAb and then re-incubated with human recombinant chymase (hrChymase, 0.325 μg/mL) or 10 μL of rat serum (for ACE) in 50 mM Tris-HCl buffer solution containing 150 mM NaCl (pH 8.0) for 30 min at 37
o
C. The reaction was stopped by adding an equal volume of 1% phosphoric acid and
125
I-Ang metabolic products were quantified by HPLC connected to an in-line flow-through gamma detector. Anti-Ang-(1-12) pAb showed high specificity for the human Ang-(1-12) sequence (EC
50
= 29.6 ng/mL) and negligible cross-reactivity with closely related angiotensin peptides. The non-neutralized human
125
I-Ang-(1-12) substrate was rapidly metabolized by both hrChymase and rat serum ACE to
125
I-Ang II (81% and 35%, respectively). In contrast, generation of
125
I-Ang II from neutralized
125
I-Ang-(1-12) substrate by either hrChymase or ACE was only 17% and 7%, respectively. The effective and potent blockade of Ang II generation from either chymase or ACE by combining Ang-(1-12) with an anti-Ang-(1-12) pAb now paves the way to develop new therapeutic approaches to hypertension treatment using Ang-(1-12) antibodies directed against the human sequence of this Ang II-forming substrate.
Collapse
|
29
|
Ahmad S, Wright KN, Sun X, Groban L, Ferrario CM. Mast cell peptidases (carboxypeptidase A and chymase)-mediated hydrolysis of human angiotensin-(1-12) substrate. Biochem Biophys Res Commun 2019; 518:651-656. [PMID: 31466718 DOI: 10.1016/j.bbrc.2019.08.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/17/2019] [Indexed: 02/07/2023]
Abstract
Angiotensin processing peptidases (carboxypeptidase A (CPA) and chymase) are stored in cardiac mast cell (MC) secretory granules in large quantity and are co-released into the extracellular environment after activation/degranulation. In the human heart, chymase is primarily responsible for angiotensin II (Ang II) generation from the alternate substrate angiotensin-(1-12) (Ang-(1-12)). We investigated the individual and combined hydrolytic specificity of CPA and chymase enzymes (1:1 and 1:⅓ ratio) in the processing of the human Ang-(1-12) (hAng-(1-12)) substrate. To determine the Km and Vmax, the CPA and recombinant human chymase (rhChymase) enzymes were incubated with increasing concentrations of hAng-(1-12) substrate (0-300 μM). We found that CPA alone sequentially metabolized hAng-(1-12) substrate into angiotensin-(1-9) (Ang-(1-9), 53%), Ang II (22%) and angiotensin-(1-7) (Ang-(1-7), 11%) during a 15 min incubation. In the presence of rhChymase alone, 125I-hAng-(1-12) was directly metabolized into Ang II (89%) and no further hydrolysis of Ang II was detected. In the presence of both CPA + rhChymase enzymes (1:1 or 1:⅓ ratio), the amount of Ang II formation from 125I-hAng-(1-12) within a 5 min incubation period were 68% or 65%, respectively. In the presence of both (CPA + rhChymase), small amounts of Ang-(1-9) and Ang-(1-7) were generated from 125I-hAng-(1-12). The Km and Vmax values were 150 ± 5 μM and 384 ± 23 nM/min/mg of CPA and 40 ± 9 μM and 116 ± 20 nM/min/mg of rhChymase. The catalytic efficiency (Vmax/Km ratio) was higher for rhChymase/hAng-(1-12) compared to CPA/hAng-(1-12). Compared to CPA, chymase has a much higher affinity to hydrolyze the hAng-(1-12) substrate directly into Ang II. In addition, Ang II and Ang-(1-7) are the end products of chymase and CPA, respectively. Overall, our findings suggest that the Ang II generation from hAng-(1-12) is primarily mediated by chymase rather than CPA.
Collapse
Affiliation(s)
- Sarfaraz Ahmad
- General Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
| | - Kendra N Wright
- General Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Xuming Sun
- Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Leanne Groban
- Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA; Internal Medicine/Molecular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| | - Carlos M Ferrario
- General Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA
| |
Collapse
|
30
|
Alencar AKN, Montes GC, Costa DG, Mendes LVP, Silva AMS, Martinez ST, Trachez MM, Cunha VDMN, Montagnoli TL, Fraga AGM, Wang H, Groban L, Fraga CAM, Sudo RT, Zapata-Sudo G. Cardioprotection Induced by Activation of GPER in Ovariectomized Rats With Pulmonary Hypertension. J Gerontol A Biol Sci Med Sci 2019; 73:1158-1166. [PMID: 29790948 DOI: 10.1093/gerona/gly068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 04/26/2018] [Indexed: 01/09/2023] Open
Abstract
Pulmonary hypertension (PH) is a disease of women (female-to-male ratio 4:1), and is associated with cardiac and skeletal muscle dysfunction. Herein, the activation of a new estrogen receptor (GPER) by the agonist G1 was evaluated in oophorectomized rats with monocrotaline (MCT)-induced PH. Depletion of estrogen was induced by bilateral oophorectomy (OVX) in Wistar rats. Experimental groups included SHAM or OVX rats that received a single intraperitoneal injection of MCT (60 mg/kg) for PH induction. Animals received s.c. injection of either vehicle or G1, a GPER agonist, (400 µg/kg/day) for 14 days after the onset of disease. Rats with PH exhibited exercise intolerance and cardiopulmonary alterations, including reduced pulmonary artery flow, biventricular remodeling, and left ventricular systolic and diastolic dysfunction. The magnitude of these PH-induced changes was significantly greater in OVX versus SHAM rats. G1 treatment reversed both cardiac and skeletal muscle functional aberrations caused by PH in OVX rats. G1 reversed PH-related cardiopulmonary dysfunction and exercise intolerance in female rats, a finding that may have important implications for the ongoing clinical evaluation of new drugs for the treatment of the disease in females after the loss of endogenous estrogens.
Collapse
Affiliation(s)
- Allan K N Alencar
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Guilherme C Montes
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Daniele G Costa
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Luiza V P Mendes
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil.,Departamento de Farmacologia, Universidade Estácio de Sá, Rio de Janeiro, Brazil
| | - Ananssa M S Silva
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Sabrina T Martinez
- Departamento de Química, Instituto de Química, Campus do Valonguinho, Universidade Federal Fluminense, Niterói - RJ, Brazil
| | - Margarete M Trachez
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Valéria do M N Cunha
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Tadeu L Montagnoli
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Aline G M Fraga
- Faculdade de Farmácia da Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Ilha do Fundão Cidade Universitária, Brazil
| | - Hao Wang
- Departments of Anesthesiology and Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Leanne Groban
- Departments of Anesthesiology and Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Carlos A M Fraga
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Roberto T Sudo
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Gisele Zapata-Sudo
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| |
Collapse
|
31
|
Wang H, Sun X, Hodge HS, Ferrario CM, Groban L. NLRP3 inhibition improves heart function in GPER knockout mice. Biochem Biophys Res Commun 2019; 514:998-1003. [PMID: 31092335 DOI: 10.1016/j.bbrc.2019.05.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 05/06/2019] [Indexed: 12/11/2022]
Abstract
The molecular mechanisms of postmenopausal heart diseases in women may involve the loss of estrogen-deactivation of its membrane receptor, G-protein coupled estrogen receptor (GPER), and subsequent activation of the cardiac NLRP3 inflammasome, a component of the innate immune system. To study the potential effects of cardiac GPER on NLRP3-mediated inflammatory pathways, we characterized changes in innate immunity gene transcripts in hearts from 6-month-old cardiomyocyte-specific GPER knockout (KO) mice and their GPER-intact wild type (WT) littermates using RT2 Profiler™ real-time PCR array. GPER deletion in cardiomyocytes decreased %fractional shortening (%FS) and myocardial relaxation (e'), and increased the early mitral inflow filling velocity-to-early mitral annular descent velocity ratio (E/e'), determined by echocardiography, and increased the mRNA levels of atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP), determined by real-time PCR. Of the 84 inflammasome-related genes tested, 9 genes were upregulated, including NLRP3 and IL-18, while 1 gene, IL-12a, was downregulated in GPER KO when compared to WT. The importance of NLRP3 upregulation in GPER KO-induced heart failure was further confirmed by an in vivo study showing that, compared to vehicle-treated KO mice, 8 weeks of treatment with a NLRP3 inhibitor, MCC950 (10 mg/kg, i.p., 3 times per week), significantly limited hypertrophic remodeling, defined by reductions in heart weight/body weight, and improved systolic and diastolic functional indices, including increases in %FS and e', and decreases E/e' (P < 0.05). Both ANF and BNP mRNA levels were also significantly reduced by chronic MCC950 treatment. The findings from this study point toward a new understanding for the increased occurrence of heart diseases in women following loss or absence of estrogenic protection and GPER activation that involves cardiac NLRP3 inflammatory pathways.
Collapse
Affiliation(s)
- Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157-1009, USA; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA.
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157-1009, USA.
| | - Hunter S Hodge
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157-1009, USA.
| | - Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA; Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA.
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157-1009, USA; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA.
| |
Collapse
|
32
|
Wang H, Sun X, Ahmad S, Su J, Ferrario CM, Groban L. Estrogen Modulates the Differential Expression of Cardiac Myocyte Chymase Isoforms and Diastolic Function. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.576.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hao Wang
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | - Xuming Sun
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | - Sarfaraz Ahmad
- General SurgeryWake Forest School of MedicineWinston‐SalemNC
| | - Jing Su
- Biostatistical SciencesWake Forest School of MedicineWinston‐SalemNC
| | | | - Leanne Groban
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| |
Collapse
|
33
|
Ahmad S, Wright KN, Varagic J, Groban L, Ferrario CM. Mast Cell Peptidases (Carboxypeptidase A and Chymase)‐Mediated Hydrolysis of Human Angiotensin‐(1‐12). FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.577.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarfaraz Ahmad
- General SurgeryWake Forest University Health SciencesWinston‐SalemNC
| | - Kendra N Wright
- General SurgeryWake Forest University Health SciencesWinston‐SalemNC
| | - Jasmina Varagic
- Hypertension and Vascular ResearchWake Forest University Health SciencesWinston‐SalemNC
| | - Leanne Groban
- AnesthesiologyWake Forest University Health SciencesWinston‐SalemNC
| | - Carlos M Ferrario
- General SurgeryWake Forest University Health SciencesWinston‐SalemNC
| |
Collapse
|
34
|
Sun X, Wright KN, Hodge HS, Ahmad S, Varagic J, Wang H, Ferrario CM, Groban L. Equivalence of G1/GPER Monotherapy Compared with Dual Administration of G1 and Lisinopril in Preventing Diastolic Dysfunction due to Estrogen Loss in SHR. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.532.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Xuming Sun
- AnesthesiologyWake Forest School of MedicineWinston SalemNC
| | | | - Hunter S Hodge
- AnesthesiologyWake Forest School of MedicineWinston SalemNC
| | | | | | - Hao Wang
- AnesthesiologyWake Forest School of MedicineWinston SalemNC
| | | | - Leanne Groban
- AnesthesiologyWake Forest School of MedicineWinston SalemNC
| |
Collapse
|
35
|
Yamashita T, Ahmad S, Wright KN, VonCannon JL, Varagic J, Sun X, Wang H, Groban L, Ferrario CM. Primacy of Chymase over Angiotensin Converting Enzyme in the Production of Angiotensin II in Rat Bone Marrow Tissue. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.577.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Sarfaraz Ahmad
- Department of General SurgeryWake Forest UniversityWinston SalemNC
| | - Kendra N Wright
- Department of General SurgeryWake Forest UniversityWinston SalemNC
| | | | - Jasmina Varagic
- Department of General SurgeryWake Forest UniversityWinston SalemNC
| | - Xuming Sun
- Department of AnesthesiologyWake Forest UniversityWinston SalemNC
| | - Hao Wang
- Department of AnesthesiologyWake Forest UniversityWinston SalemNC
| | - Leanne Groban
- Department of AnesthesiologyWake Forest UniversityWinston SalemNC
| | | |
Collapse
|
36
|
Wang H, Sun X, Ahmad S, Su J, Ferrario CM, Groban L. Estrogen modulates the differential expression of cardiac myocyte chymase isoforms and diastolic function. Mol Cell Biochem 2019; 456:85-93. [PMID: 30712071 DOI: 10.1007/s11010-018-03492-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/22/2018] [Indexed: 01/21/2023]
Abstract
Chymases, a family of serine proteases with chymotryptic activity, play a significant role in cardiac angiotensin II (Ang II) formation from its substrate Ang-(1-12) in both human and rodent models. No studies, to date, have assessed the differences in enzymatic activity among these isoforms in Ang II formation, particularly in the cardiomyocyte (CM). Using PCR and DNA sequencing, we demonstrated that MCP-1, MCP-2, MCP-4, and MCP-5 mRNAs are expressed in the CM of both spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). While rMCP-1 and rMCP-5 gene transcripts were higher than that of other isoforms in both rat strains, WKY CM exhibits higher levels of rMCP-1 and rMCP-5 mRNAs compared to the SHR CM. Ovariectomy (OVX) increased the expression of rMCP-1 and rMCP-5 mRNAs in WKY. In SHR, OVX was associated with a blunted increase in rMCP-1 mRNA compared to OVX normotensive WKY. Chymase activity, measured as Ang II formation from Ang-(1-12), significantly correlated with rMCP-1 and rMCP-5 mRNA expression in both rat strains. Both rMCP-1 and rMCP-5 mRNA expressions were positively correlated with progressive diastolic dysfunction (increasing the ratio of early mitral inflow velocity-to-early mitral annular velocity, E/e') and expanding chamber dimensions or increasing left ventricular internal diameter end diastole. These data show rMCP-1 and rMCP-5 as the Ang II forming chymase isoforms participating in the loss of normal cardiac function due to OVX in rodents.
Collapse
Affiliation(s)
- Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA. .,Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Jing Su
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Blvd, 27157, Winston-Salem, NC, USA
| | - Carlos Maria Ferrario
- Department of Surgery, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.,Department of Physiology and Pharmacology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.,Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.,Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| |
Collapse
|
37
|
Groban L, Tran QK, Ferrario CM, Sun X, Cheng CP, Kitzman DW, Wang H, Lindsey SH. Female Heart Health: Is GPER the Missing Link? Front Endocrinol (Lausanne) 2019; 10:919. [PMID: 31993020 PMCID: PMC6970950 DOI: 10.3389/fendo.2019.00919] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
The G Protein-Coupled Estrogen Receptor (GPER) is a novel membrane-bound receptor that mediates non-genomic actions of the primary female sex hormone 17β-estradiol. Studies over the past two decades have elucidated the beneficial actions of this receptor in a number of cardiometabolic diseases. This review will focus specifically on the cardiac actions of GPER, since this receptor is expressed in cardiomyocytes as well as other cells within the heart and most likely contributes to estrogen-induced cardioprotection. Studies outlining the impact of GPER on diastolic function, mitochondrial function, left ventricular stiffness, calcium dynamics, cardiac inflammation, and aortic distensibility are discussed. In addition, recent data using genetic mouse models with global or cardiomyocyte-specific GPER gene deletion are highlighted. Since estrogen loss due to menopause in combination with chronological aging contributes to unique aspects of cardiac dysfunction in women, this receptor may provide novel therapeutic effects. While clinical studies are still required to fully understand the potential for pharmacological targeting of this receptor in postmenopausal women, this review will summarize the evidence gathered thus far on its likely beneficial effects.
Collapse
Affiliation(s)
- Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, United States
- Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States
- *Correspondence: Leanne Groban
| | - Quang-Kim Tran
- Department of Physiology & Pharmacology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, United States
| | - Carlos M. Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC, United States
- Department of Physiology-Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Che Ping Cheng
- Department of Internal Medicine, Cardiovascular Medicine Section, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Dalane W. Kitzman
- Department of Internal Medicine, Cardiovascular Medicine Section, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC, United States
- Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Sarah H. Lindsey
- Department of Pharmacology, Tulane University, New Orleans, LA, United States
| |
Collapse
|
38
|
Kavanagh K, Hsu F, Davis A, Groban L, Kritchevsky S, Rejeski J, Kim S. BIOMARKERS OF LEAKY GUT ARE RELATED TO INFLAMMATION AND REDUCED PHYSICAL FUNCTION IN UNHEALTHY OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - F Hsu
- Wake Forest School of Medicine
| | - A Davis
- Wake Forest School of Medicine
| | | | | | | | - S Kim
- Wake Forest School of Medicine
| |
Collapse
|
39
|
Wang H, Sun X, Lin MS, Ferrario CM, Van Remmen H, Groban L. G protein-coupled estrogen receptor (GPER) deficiency induces cardiac remodeling through oxidative stress. Transl Res 2018; 199:39-51. [PMID: 29758174 PMCID: PMC6151279 DOI: 10.1016/j.trsl.2018.04.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/09/2018] [Accepted: 04/22/2018] [Indexed: 12/21/2022]
Abstract
Oxidative stress has been implicated in the unfavorable changes in cardiac function and remodeling that occur after ovarian estrogen loss. Using ovariectomized rat models, we previously reported that the cardioprotective actions of estrogen are mediated by the G protein-coupled estrogen receptor (GPER). Here, in 9-month-old, female cardiomyocyte-specific GPER knockout (KO) mice vs sex- and age-matched wild-type (WT) mice, we found increased cardiac oxidative stress and oxidant damage, measured as a decreased ratio of reduced glutathione to oxidized glutathione, increased 4-hydroxynonenal and 8-hydroxy-2'-deoxyguanosine (8-oxo-DG) staining, and increased expression of oxidative stress-related genes. GPER KO mice also displayed increased heart weight, cardiac collagen deposition, and Doppler-derived filling pressure, and decreased percent fractional shortening and early mitral annular velocity compared with WT controls. Treatment of GPER KO mice for 8 weeks with phosphonium [10-(4,5-dimethoxy-2-methyl 3,6-dioxo-1,4-cyclohexadien-1-yl)decyl] triphenyl-,mesylate (MitoQ), a mitochondria-targeted antioxidant, significantly attenuated these measures of cardiac dysfunction, and MitoQ decreased 8-oxo-DG intensity compared with treatment with an inactive comparator compound, (1-decyl)triphenylphosphonium bromide (P <0.05). A real-time polymerase chain reaction array analysis of 84 oxidative stress and antioxidant defense genes revealed that MitoQ attenuates the increase in NADPH oxidase 4 and prostaglandin-endoperoxide synthase 2 and the decrease in uncoupling protein 3 and glutathione S-transferase kappa 1 seen in GPER KO mice. Our findings suggest that the cardioprotective effects of GPER include an antioxidant role and that targeted strategies to limit oxidative stress after early noncancerous surgical extirpation of ovaries or menopause may help limit alterations in cardiac structure and function related to estrogen loss.
Collapse
Affiliation(s)
- Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Xuming Sun
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Marina S Lin
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Holly Van Remmen
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma; Biomedical Research Service, Oklahoma City VA Healthcare System, Oklahoma City, Oklahoma
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina; Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina.
| |
Collapse
|
40
|
da Silva JS, Gabriel-Costa D, Wang H, Ahmad S, Sun X, Varagic J, Sudo RT, Ferrario CM, Dell Italia LJ, Sudo GZ, Groban L. Blunting of cardioprotective actions of estrogen in female rodent heart linked to altered expression of cardiac tissue chymase and ACE2. J Renin Angiotensin Aldosterone Syst 2018; 18:1470320317722270. [PMID: 28748720 PMCID: PMC5805468 DOI: 10.1177/1470320317722270] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Diastolic dysfunction develops in response to hypertension and estrogen (E2) loss and is a forerunner to heart failure (HF) in women. The cardiac renin–angiotensin system (RAS) contributes to diastolic dysfunction, but its role with respect to E2 and blood pressure remain unclear. Methods: We compared the effects of ovariectomy (OVX) or sham surgery on the cardiac RAS, left ventricular (LV) structure/function, and systemic/intracardiac pressures of spontaneously hypertensive rats (SHRs: n = 6 intact and 6 OVX) and age-matched Wistar-Kyoto (WKY: n = 5 intact and 4 OVX) controls. Results: WKY rats were more sensitive to OVX than SHRs with respect to worsening of diastolic function, as reflected by increases in Doppler-derived filling pressures (E/e′) and reductions in myocardial relaxation (e′). This pathobiologic response in WKY rats was directly linked to increases in cardiac gene expression and enzymatic activity of chymase and modest reductions in ACE2 activity. No overt changes in cardiac RAS genes or activities were observed in SHRs, but diastolic function was inversely related to ACE2 activity. Conclusion: Endogenous estrogens exert a more significant regulatory role upon biochemical components of the cardiac RAS of WKY versus SHRs, modulating the lusitropic and structural components of its normotensive phenotype.
Collapse
Affiliation(s)
- Jacqueline S da Silva
- 1 Research Program Development of Drugs, Institute of Biomedical Sciences Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniele Gabriel-Costa
- 1 Research Program Development of Drugs, Institute of Biomedical Sciences Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hao Wang
- 2 The Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.,3 The Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Sarfaraz Ahmad
- 4 The Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Xuming Sun
- 2 The Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Jasmina Varagic
- 4 The Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Roberto T Sudo
- 1 Research Program Development of Drugs, Institute of Biomedical Sciences Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos M Ferrario
- 4 The Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.,5 The Department of Internal Medicine-Nephrology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Louis J Dell Italia
- 6 Division of Cardiovascular Disease, University of Alabama at Birmingham and Department of Veterans Affairs, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Gisele-Zapata Sudo
- 1 Research Program Development of Drugs, Institute of Biomedical Sciences Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leanne Groban
- 2 The Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.,3 The Department of Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| |
Collapse
|
41
|
Kim S, Neiberg R, Rejeski WJ, Marsh AP, Kritchevsky SB, Leng XI, Groban L. Self-reported mobility as a preoperative risk assessment tool in older surgical patients compared to the American College of Surgeons National Surgical Quality Improvement Program. Perioper Med (Lond) 2018; 7:12. [PMID: 29951202 PMCID: PMC6010168 DOI: 10.1186/s13741-018-0095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/04/2018] [Indexed: 11/12/2022] Open
Abstract
Background The American College of Surgeons National Surgical Quality Improvement Program (NSQIP®) developed a surgical risk calculator using data from 1.4 million patients and including 1557 unique Current Procedural Terminology (CPT) codes. Although this calculator demonstrated excellent performance in predicting postoperative mortality, morbidity, and six surgical complications, it was not developed specifically for use in older surgical patients who have worse surgical outcomes and additional unique risk factors compared to younger adults. We aimed to test the ability of a simple self-reported mobility tool to predict postoperative outcomes in the older surgical population compared to the NSQIP. Methods We used data from a prospective cohort study that enrolled 197 older surgical patients (≥ 69 years) undergoing various elective surgeries and assessed 30-day surgical outcomes. Statistical models included data from the Mobility Assessment Tool-short form (MAT-sf) alone, covariates alone, and MAT-sf data and covariates. We used leave-one-out (LOO) cross-validation of the models within our cohort and compared their performance for predicting postoperative outcomes against the NSQIP calculator based on receiver operating characteristic area under the curve (ROC AUC). Results Patients with poor self-reported mobility experienced higher rates of postoperative complications and nursing home placement. There was no difference in performance between any of our models and the NSQIP calculator (p > 0.1), with AUC between 0.604 and 0.697 for predicting postoperative complications and 0.653 and 0.760 for predicting nursing home placement. All models also predicted a length of stay (LOS) similar to the actual LOS. Conclusion Mobility assessment alone using MAT-sf can predict postoperative complications, nursing home placement, and LOS for older surgical patients, with accuracy comparable to that of the NSQIP calculator. The simplicity of this noninvasive risk assessment tool makes it an attractive alternative to the NSQIP calculator that requires 20 patient predictors and the planned procedure, or CPT code to predict the chance that patients will have 15 different adverse outcomes following surgery.
Collapse
Affiliation(s)
- Sunghye Kim
- 1Department of Internal Medicine, Section of General Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA.,2Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Rebecca Neiberg
- 3Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, 525 Vine, Winston-Salem, NC 27101 USA
| | - W Jack Rejeski
- 4Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC 27109 USA
| | - Anthony P Marsh
- 4Department of Health and Exercise Science, Wake Forest University, PO Box 7868, Winston-Salem, NC 27109 USA
| | - Stephen B Kritchevsky
- 2Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Xiaoyan I Leng
- 3Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, 525 Vine, Winston-Salem, NC 27101 USA
| | - Leanne Groban
- 2Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA.,5Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009 USA
| |
Collapse
|
42
|
Groban L, Wang H, Sun X, Ferrario CM. Knockdown of GPER in Cardiomyocytes Activates NLRP3 Pathways. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.718.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leanne Groban
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | - Hao Wang
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | - Xuming Sun
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | | |
Collapse
|
43
|
Varagic J, Ahmad S, Ola M, VonCannon JL, Wright K, Ramirez SR, Wang H, Groban L, Cheng CP, Ferrario CM. Development of Isolated Diastolic Dysfunction Associated with Early Impairment in Coronary Blood Flow in Hypertensive Diabetes. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.903.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jasmina Varagic
- Hypertension and Vascular ResearchWake Forest School of MedicineWinston SalemNC
- Department of SurgeryWake Forest School of MedicineWinston SalemNC
| | - Sarfaraz Ahmad
- Department of SurgeryWake Forest School of MedicineWinston SalemNC
| | - Mohammad Ola
- Department of BiochemistryCollege of ScienceKing Saud UniversityRiyadhSaudi Arabia
| | | | - Kendra Wright
- Department of SurgeryWake Forest School of MedicineWinston SalemNC
| | | | - Hao Wang
- Department of AnesthesiologyWake Forest School of MedicineWinston SalemNC
| | - Leanne Groban
- Department of AnesthesiologyWake Forest School of MedicineWinston SalemNC
| | - Che Ping Cheng
- Department of Internal MedicineWake Forest School of MedicineWinston SalemNC
| | | |
Collapse
|
44
|
Groban L, Silva J, Sun X, Ahmad S, Sudo R, Wang H, Ferrario C, Zapata‐Sudo G. GPER Agonist G1, but Not Other Specific ERs Improves Diastolic Function and Attenuates Cardiac RAS Activation in Estrogen‐deficient SHR. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.584.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leanne Groban
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | | | - Xuming Sun
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | | | - Roberto Sudo
- Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
| | - Hao Wang
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | | | | |
Collapse
|
45
|
Groban L, Sun X, Ferrario CM, Wang H. The Mitochondrial‐targeted Antioxidant MitoQ Attenuates LV Dysfunction and Gene Expression Related to Oxidative Stress in Cardiomyocyte‐specific GPER KO Female Mice. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.618.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leanne Groban
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | - Xuming Sun
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| | | | - Hao Wang
- AnesthesiologyWake Forest School of MedicineWinston‐SalemNC
| |
Collapse
|
46
|
Kim S, Duncan PW, Groban L, Segal H, Abbott RM, Williamson JD. Patient-Reported Outcome Measures (PROM) as A Preoperative Assessment Tool. J Anesth Perioper Med 2017; 4:274-281. [PMID: 29333531 PMCID: PMC5766034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM OF REVIEW Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. METHODS Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades. RECENT FINDINGS Preoperative depression has been linked to postoperative delirium, complications, persistent pain, longer lengths of stay, and mortality. Socioeconomic status associates with overall and cancer-free survival. Low socioeconomic status has also been connected to medication non- compliance. Social support can predict overall and cancer- free survival, as well as physical, social and emotional quality of life. Poor functional status and frailty have been related to postoperative complications, longer lengths of stay, post-discharge institutionalization, and higher costs. Preoperative cognitive impairment also associates with self-medication management errors, postoperative cognitive impairment, delirium, complications and mortality. In addition, a greater tendency for reduced adherence to preoperative medication instructions has been linked to health illiteracy. Preoperative malnutrition is prevalent and associates with postoperative morbidity. CONCLUSION Efficient and effective assessments of social and behavioral determinants of health, functional status, health literacy, patient's perception of health, and preferences for self-management may improve postoperative management and surgical outcomes, particularly among vulnerable patients undergoing elective surgery who might have subtle physical, social, or psychological deficits or challenges, otherwise missed upon routine evaluation. Patient Reported Outcome Measures (PROMs) can be used to effectively and efficiently collect these factors in the preoperative period, thereby identifying areas that can be intervened preemptively. (Partially Funded by the National Institute on Aging and the Wake Forest University Claude D. Pepper Older Americans Independence Center.).
Collapse
Affiliation(s)
- Sunghye Kim
- Department of Internal Medicine, Winston-Salem, NC, USA,Sticht Center on Aging, Winston-Salem, NC, USA
| | - Pamela W. Duncan
- Sticht Center on Aging, Winston-Salem, NC, USA,Department of Neurology, Winston-Salem, NC, USA
| | - Leanne Groban
- Sticht Center on Aging, Winston-Salem, NC, USA,Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hannah Segal
- Fisher Center for Hereditary Cancer AND Clinical Genomics Research, Georgetown University, Washington, D.C., USA
| | | | - Jeff D. Williamson
- Department of Internal Medicine, Winston-Salem, NC, USA,Sticht Center on Aging, Winston-Salem, NC, USA
| |
Collapse
|
47
|
Kim S, Duncan P, Groban L, Segal H, Abbott RM, Williamson J. Patient-Reported Outcome Measures (PROM) as A Preoperative Assessment Tool. ACTA ACUST UNITED AC 2017. [DOI: 10.24015/japm.2017.0081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
48
|
Wang H, da Silva J, Alencar A, Zapata-Sudo G, Lin MR, Sun X, Ahmad S, Ferrario CM, Groban L. Mast Cell Inhibition Attenuates Cardiac Remodeling and Diastolic Dysfunction in Middle-aged, Ovariectomized Fischer 344 × Brown Norway Rats. J Cardiovasc Pharmacol 2017; 68:49-57. [PMID: 26981683 DOI: 10.1097/fjc.0000000000000385] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The incidence of left ventricular diastolic dysfunction (LVDD) increases in women after menopause, yet the mechanisms are unclear. Because mast cells participate in the pathological processes of various cardiac diseases, we hypothesized that mast cell inhibition would protect against estrogen loss-induced LVDD. The mast cell stabilizer, cromolyn sodium (30 mg·kg·d), or vehicle was administered subcutaneously by osmotic minipump to ovariectomized (OVX) female Fischer 344 × Brown Norway (F344BN) rats starting at 4 weeks after surgery. Eight weeks after OVX, systolic blood pressure increased by 20% in OVX versus sham rats, and this effect was attenuated after 4 weeks of cromolyn treatment. Also, cromolyn mitigated the adverse reductions in myocardial relaxation (e') and increases in left ventricle (LV) filling pressures (E/e'), LV mass, wall thicknesses, and interstitial fibrosis from OVX. Although cardiac mast cell number was increased after OVX, cardiac chymase activity was not overtly altered by estrogen status and tended to decrease by cromolyn. Contrariwise, Ang II content was greater in hearts of OVX versus sham rats, and cromolyn attenuated this effect. Taken together, mast cell inhibition with cromolyn attenuates LV remodeling and LVDD in OVX-Fischer 344 × Brown Norway rats possibly through actions on the heart level and/or through vasodilatory effects at the vascular level.
Collapse
Affiliation(s)
- Hao Wang
- *Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC;†Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC;‡Institute of Biomedical Sciences, Drug Development Program, Federal University of Rio de Janeiro, Brazil;§Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC;¶Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC;‖Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC; and**Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, NC
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Ahmad S, Sun X, Lin M, Varagic J, Zapata-Sudo G, Ferrario CM, Groban L, Wang H. Blunting of estrogen modulation of cardiac cellular chymase/RAS activity and function in SHR. J Cell Physiol 2017; 233:3330-3342. [PMID: 28888034 DOI: 10.1002/jcp.26179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/24/2017] [Indexed: 12/16/2022]
Abstract
The relatively low efficacy of ACE-inhibitors in the treatment of heart failure in women after estrogen loss may be due to their inability to reach the intracellular sites at which angiotensin (Ang) II is generated and/or the existence of cell-specific mechanisms in which ACE is not the essential processing pathway for Ang II formation. We compared the metabolic pathway for Ang II formation in freshly isolated myocytes (CMs) and non-myocytes (NCMs) in cardiac membranes extracted from hearts of gonadal-intact and ovariectomized (OVX) adult WKY and SHR rats. Plasma Ang II levels were higher in WKY vs. SHR (strain effect: WKY: 62 ± 6 pg/ml vs. SHR: 42 ± 9 pg/ml; p < 0.01), independent of OVX. The enzymatic activities of chymase, ACE, and ACE2 were higher in NCMs versus CMs, irrespective of whether assays were performed in cardiac membranes from WKY or SHR or in the presence or absence of OVX. E2 depletion increased chymase activity, but not ACE activity, in both CMs and NCMs. Moreover, cardiac myocyte chymase activity associated with diastolic function in WKYs and cardiac structure in SHRs while no relevant functional and structural relationships between the classic enzymatic pathway of Ang II formation by ACE or the counter-regulatory Ang-(1-7) forming path from Ang II via ACE2 were apparent. The significance of these novel findings is that targeted cell-specific chymase rather than ACE inhibition may have a greater benefit in the management of HF in women after menopause.
Collapse
Affiliation(s)
- Sarfaraz Ahmad
- Departments of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Xuming Sun
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Marina Lin
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jasmina Varagic
- Departments of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Gisele Zapata-Sudo
- Division of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos M Ferrario
- Departments of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Physiology-Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Leanne Groban
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Hao Wang
- Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Internal Medicine-Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
50
|
da Silva JS, Gabriel-Costa D, Sudo RT, Wang H, Groban L, Ferraz EB, Nascimento JHM, Fraga CAM, Barreiro EJ, Zapata-Sudo G. Adenosine A 2A receptor agonist prevents cardiac remodeling and dysfunction in spontaneously hypertensive male rats after myocardial infarction. Drug Des Devel Ther 2017; 11:553-562. [PMID: 28293100 PMCID: PMC5345997 DOI: 10.2147/dddt.s113289] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background This work evaluated the hypothesis that 3,4-methylenedioxybenzoyl-2-thienylhydrazone (LASSBio-294), an agonist of adenosine A2A receptor, could be beneficial for preventing cardiac dysfunction due to hypertension associated with myocardial infarction (MI). Methods Male spontaneously hypertensive rats (SHR) were randomly divided into four groups (six animals per group): sham-operation (SHR-Sham), and myocardial infarction rats (SHR-MI) were treated orally either with vehicle or LASSBio-294 (10 and 20 mg.kg−1.d−1) for 4 weeks. Echocardiography and in vivo hemodynamic parameters measured left ventricle (LV) structure and function. Exercise tolerance was evaluated using a treadmill test. Cardiac remodeling was accessed by LV collagen deposition and tumor necrosis factor α expression. Results Early mitral inflow velocity was significantly reduced in the SHR-MI group, and there was significant recovery in a dose-dependent manner after treatment with LASSBio-294. Exercise intolerance observed in the SHR-MI group was prevented by 10 mg.kg−1.d−1 of LASS-Bio-294, and exercise tolerance exceeded that of the SHR-Sham group at 20 mg.kg−1.d−1. LV end-diastolic pressure increased after MI, and this was prevented by 10 and 20 mg.kg−1.d−1 of LASSBio-294. Sarcoplasmic reticulum Ca2+ ATPase levels were restored in a dose-dependent manner after treatment with LASSBio-294. Fibrosis and inflammatory processes were also counteracted by LASSBio-294, with reductions in LV collagen deposition and tumor necrosis factor α expression. Conclusion In summary, oral administration of LASSBio-294 after MI in a dose-dependent manner prevented the development of cardiac dysfunction, demonstrating this compound’s potential as an alternative treatment for heart failure in the setting of ischemic heart disease with superimposed chronic hypertension.
Collapse
Affiliation(s)
- Jaqueline S da Silva
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniele Gabriel-Costa
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto T Sudo
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hao Wang
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Emanuele B Ferraz
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Hamilton M Nascimento
- Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos Alberto M Fraga
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliezer J Barreiro
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gisele Zapata-Sudo
- Research Program Development of Drugs, Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|